Senate Democrats’ coalition on health reform said to be fracturing

With debate on the Senate healthcare bill to begin this week, media reports indicate that Senate Majority Leader Harry Reid (D-NV) faces a difficult challenge in herding the 60 votes needed to advance the legislation. The AP (11/30) reports, “The 60 votes aren’t there any more. With the Senate set to begin debate Monday on healthcare overhaul, the all-hands-on-deck Democratic coalition that allowed the bill to advance is fracturing already.” The AP notes the fractures include divisions on abortion and the public option, and the stakes for Reid. The public is “ambivalent about the Democrats’ legislation. While 58% want elected officials to tackle healthcare now, about half of those supporters say they don’t like what they’re hearing about the plans, according to a new Kaiser Family Foundation poll.”

Politico (11/30, Brown) reports the “next phase in the Democrats’ healthcare push will be waged in the privacy of the Senate leadership office,” where Reid “will attempt to do something that has eluded him all year: negotiate a compromise on the public insurance option that can garner 60 votes and win over a public still leery of reform.” Republicans want “six weeks of debate — which would be enough to push the final vote past Christmas — and have an arsenal of stalling tactics. But Democrats can short-circuit the debate all at once, simply by reaching a deal on the public option and filing cloture on the bill, which would set up the final crucial test vote before final passage.”

The Hill (11/30, Young) lists seven issues likely to come up in the amendments to the Senate bill, including the public option, abortion, the health insurance excise tax on “high-cost health insurance plans,” which “may enjoy support in the White House but many Democrats and labor unions remain staunchly opposed to what they view as a middle-class tax hike”; prescription drugs, affordability, insurance exchanges and Medicare cuts. The Wall Street Journal (11/30, Bendavid, subscription required) also reports on amendments that will likely affect the course of the bill, noting that proposals made by both conservative and liberal lawmakers will complicate the bill’s progress. Meanwhile, USA Today (11/30, Fritze) discusses the senators who are expected to play a key role in the debate.

Senate leaders face challenges in passing healthcare reform. CQ Weekly (11/30, Wayne, Armstrong, subscription required) reports, “Despite a narrow and hard-won victory in their quest to bring healthcare overhaul to the floor, Senate backers begin this week effectively facing an impasse over the legislation.” CQ adds that the “Democratic leadership barely mustered the 60 votes — on strict party lines — needed to keep Majority Leader Harry Reid’s bill alive and move it forward.” Notably, moderate Democrats who supported Reid have “served notice…that he cannot count on them to vote for passage unless the legislation is made more to their liking.”

Senate bill would delay implementation of many reforms. The Washington Post (11/30, Hilzenrath) reports, “Measured against the promises President Obama and congressional Democrats have made about healthcare reform, the bill the Senate begins debating this week could be setting Americans up for disappointment: Some of the main reforms would not take place for several years, and even when they do, some observers say, the bill does too little to make sure they would be enforced.” Until 2014, “insurance companies could continue to deny coverage or charge higher premiums based on people’s medical history.” Another “highly touted reform — banning annual and lifetime limits on coverage — would take effect in 2010, but it would permit significant exceptions.”